Key Takeaways:
- Medical identity theft is when someone steals your medical coverage information to fraudulently use it for themselves.
- Thieves commit medical identity theft to obtain healthcare benefits that are still billed to the victim.
- Physical theft, phishing scams, and data breaches are common ways this can occur.
- There are a number of signs you are a victim, such as unexpected medical bills, collection letters, prescription fills, and denied coverage.
As if medical care wasn’t stressful enough, scammers are doing their best to make things even tougher, this time through something known as medical identity theft. Let’s take a look at what it is, why they do it, and ways you can spot it before it’s too late.
What is Medical Identity Theft?
Medical identity theft is when someone steals your healthcare information (or uses your private information to sign up for healthcare plans) in order to gain medical benefits — such as receiving medical care, equipment, prescription drugs, etc. — all under your name. Essentially, they use your private information to get benefits, while you’re stuck with the bill, or worse, no access to medical care.
Why Do Scammers Steal Medical Information?
The details vary widely, but in broad terms, medical identity theft attempts to fraudulently obtain care or to extract money from the healthcare system through bogus claims. A few potential examples might include:
- A person who can’t afford insurance buys yours from a scammer.
- A person who’s uninsurable applies for, and gets, insurance using your private information.
- A person who needs costly tests or treatments claims them under your coverage, using your ID.
- A person with a drug habit secures prescriptions from multiple doctors, giving each one a separate fake identity.
- Scammers file fake claims in your name with your insurer, or with Medicare or Medicaid, for services that have not been performed.
How Medical Identity Theft Occurs
While the end goal of medical identity theft is to fraudulently obtain benefits while pawning the costs onto the victim, scammers must first get hold of the victim’s private information. Here’s how that usually happens:
- Physical theft: Criminals will steal your Medicare or Social Security card and then use that information to commit medical identity theft.
- Scams: Phishing scams are the most widely used method by criminals, where they will pretend to be from an official organization (like Medicare or other health insurance providers) and trick you into giving up private information they can later use — often through links to spoofed websites or fraudulent phone calls.
Data breaches: This one is harder to protect yourself from, as scammers with more advanced technical skills will occasionally break through security systems, revealing information en masse. While there isn’t much you can do to prevent this, keeping good online safety practices, like occasionally updating your passwords, can help keep your information safe.
Signs You’re a Victim of Medical Identity Theft
Healthcare can be plenty confusing and stressful on its own, which is why it’s important to keep an eye out for certain signs that you may be a victim of medical identity theft. Here’s what to look out for:
1. Medical Bills You Don’t Recognize
If you receive any medical bills or insurance claims that don’t track back to care you’ve received, there’s a high chance it’s someone else posing as you.
2. Explanation of Benefits (EOB) Inaccuracies
EOB statements are given by health insurance companies, detailing information like health care received and corresponding billing. If you notice errors or items you don’t recognize, it’s likely a fraudulent claim has been filed under your name.
3. Collections Notices
If you know you’re up to date on all your healthcare bills, but keep receiving collections notices for medical debts (or unexplainable drops in your credit score), that’s a pretty big indication that someone is using your medical identity.
4. Notification of Benefits Limit Reached
Some plans will have a limit to the benefits offered within a period of time. If you’re notified that you’ve hit that limit, but haven’t actually done so yourself, someone else has received services in your name.
5. Denied Claims Due to Preexisting Conditions You Don’t Have
If you are seeking care for a new medical issue, only to find you’ve been denied due to a nonexistent preexisting condition, you once again will want to look into the possibility of someone using your medical identity.
6. Unrecognized Prescription Refills
While some people use medical identity theft to get free healthcare, others are simply trying to load up on prescription pills. If you find any prescriptions filled in your name that you were never prescribed, look into the possibility that your information has been compromised.
How to Prevent Medical Identity Theft
As with any type of fraud or identity theft, there are certain things you can do to help lower your chances of becoming a victim. While there’s no way to completely eliminate the possibility, the following practices can help minimize your risk:
- Keep sensitive documents securely stored (both physically and digitally).
- Don’t share your medical information with anyone other than trusted healthcare providers.
- Don’t click any unknown links or provide information to random callers. If you’re unsure whether an email, text, or call is from whoever they claim to be, either look up the official contact information or run a Spokeo search.
- Practice good online security, like using unique and complex passwords.
- Safely dispose of old documents with private information.
- Pay attention to data breach notices and take action to re-secure your account.
- Check your explanation of benefits statements and other medical/billing statements regularly and thoroughly.
FAQs
How am I affected by medical identity theft?
When people use your identity for medical benefits, there are a number of harmful repercussions. You can be denied necessary care, get stuck with large debts, deal with higher premiums, and suffer damage to your credit score.
Someone stole my medical identity. What should I do?
If you know you are a victim of medical identity theft, immediately contact your healthcare provider. You may also want to contact your bank to see if any of your financial accounts have been compromised, as well as check in with the major credit bureaus.
Cyrus Grant is a writer from Southern California with a background in law and dispute resolution. When he isn’t writing, he can be found deep-diving into the latest technology trends or simply spending time at the beach.